Topic: Male Reproductive System
Subtopic: Vascular Supply of Penis
Keyword Definitions:
Helicine arteries: Small, coiled arteries in the corpora cavernosa of the penis responsible for erectile function by regulating blood flow.
Deep artery of penis: Main artery supplying corpora cavernosa, gives rise to helicine arteries.
External pudendal artery: Branch of femoral artery supplying skin of external genitalia, not directly giving rise to helicine arteries.
Femoral artery: Major artery of lower limb, not directly involved in penile vascularization.
Corpora cavernosa: Paired erectile tissues in penis filled by blood during erection.
Corpus spongiosum: Surrounds urethra, supplied by other arteries.
Erection mechanism: Helicine arteries dilate under parasympathetic stimulation, allowing blood into erectile tissue.
Lead Question - 2013
Helicine artery are branch of ?
a) Deep artery of penis
b) Femoral artery
c) External pudendal artery
d) None of the above
Explanation: Helicine arteries are branches of the deep artery of penis. These arteries are crucial for erectile function, as they supply the corpora cavernosa and regulate blood flow into the erectile tissue during sexual arousal. Therefore, correct answer is a) Deep artery of penis.
Guessed Question 2
Function of helicine arteries?
a) Supply corpus spongiosum
b) Supply corpora cavernosa
c) Drain venous blood
d) Supply skin of penis
Explanation: Helicine arteries are specialized branches of the deep artery of penis that supply the corpora cavernosa, regulating blood inflow during erection. Their coiled structure allows dilation. Correct answer is b) Supply corpora cavernosa.
Guessed Question 3
Which nerve controls helicine artery dilation?
a) Sympathetic
b) Parasympathetic
c) Somatic
d) None
Explanation: Parasympathetic stimulation causes helicine arteries to dilate, allowing increased blood flow into corpora cavernosa, leading to penile erection. Sympathetic stimulation causes constriction. Correct answer is b) Parasympathetic.
Guessed Question 4
Deep artery of penis is branch of?
a) Internal pudendal artery
b) External iliac artery
c) Femoral artery
d) Aorta
Explanation: The deep artery of penis is a branch of the internal pudendal artery, which supplies the penis, perineum, and adjacent structures. Correct answer is a) Internal pudendal artery.
Guessed Question 5
Clinical relevance of helicine artery dysfunction?
a) Erectile dysfunction
b) Priapism
c) Phimosis
d) Paraphimosis
Explanation: Impaired helicine artery function reduces blood inflow to corpora cavernosa, causing erectile dysfunction. Hyperfunction may lead to priapism. Correct answer is a) Erectile dysfunction.
Guessed Question 6
Which structure does NOT receive blood from helicine arteries?
a) Corpora cavernosa
b) Corpus spongiosum
c) Glans penis
d) Tunica albuginea
Explanation: Helicine arteries supply corpora cavernosa directly. Corpus spongiosum is supplied by different branches (e.g., artery of bulb of penis). Correct answer is b) Corpus spongiosum.
Guessed Question 7
Helicine arteries remain contracted in?
a) Flaccid state
b) Erect state
c) After ejaculation
d) None of the above
Explanation: In the flaccid state, helicine arteries remain contracted, limiting blood flow into corpora cavernosa. Upon arousal, they dilate. Correct answer is a) Flaccid state.
Guessed Question 8
Blockage of which artery can cause penile ischemia?
a) Deep artery of penis
b) External pudendal artery
c) Femoral artery
d) Internal thoracic artery
Explanation: Blockage of the deep artery of penis can result in insufficient blood flow to the corpora cavernosa, leading to ischemia and erectile dysfunction. Correct answer is a) Deep artery of penis.
Guessed Question 9
Which artery is not involved in penile blood supply?
a) Deep artery of penis
b) Dorsal artery of penis
c) Helicine artery
d) Coronary artery
Explanation: The coronary artery supplies the heart and has no role in penile blood supply. Other arteries supply various penile structures. Correct answer is d) Coronary artery.
Guessed Question 10
Helicine arteries' role during sexual arousal is:
a) Constrict
b) Remain unchanged
c) Dilate
d) Regress
Explanation: During sexual arousal, helicine arteries dilate under parasympathetic stimulation, allowing blood to fill the corpora cavernosa and produce erection. Correct answer is c) Dilate.
Topic: Peritoneal Cavity
Subtopic: Peritoneal Pouches in Female
Keyword Definitions:
Peritoneal cavity: Potential space between parietal and visceral peritoneum containing serous fluid.
Vesicouterine pouch: Peritoneal recess between urinary bladder and uterus.
Pouch of Douglas (Rectouterine pouch): Most dependent peritoneal recess between uterus and rectum in females.
Dependent part: Lowest part in standing position where fluid accumulates.
Clinical significance: Site for fluid collection in ascites or infections; accessible for culdocentesis.
Culdocentesis: Diagnostic procedure to aspirate fluid from pouch of Douglas.
Lead Question - 2013
Most dependent part of abdomen in standing position is ?
a) Vesicouterine pouch
b) Pouch of Douglas
c) Rectouterine pouch
d) b & c
Explanation: The most dependent part of the female peritoneal cavity in the standing position is the pouch of Douglas (also called the rectouterine pouch). Both terms describe the same anatomical space. This is clinically significant as fluid accumulates here during peritoneal infections or ascites. Therefore, correct answer is d) b & c.
Guessed Question 2
Which structure lies anterior to pouch of Douglas?
a) Rectum
b) Uterus
c) Bladder
d) Sigmoid colon
Explanation: The pouch of Douglas lies between the uterus and rectum, making the uterus anterior to it. This anatomical relation is important in clinical procedures like culdocentesis. Correct answer is b) Uterus.
Guessed Question 3
Clinical significance of pouch of Douglas?
a) Site of fluid accumulation
b) Site of tumor implantation
c) Accessible for culdocentesis
d) All of the above
Explanation: The pouch of Douglas is significant for accumulating fluid in peritoneal diseases, tumor implantation, and is accessible by culdocentesis to sample fluid for diagnosis. Correct answer is d) All of the above.
Guessed Question 4
Vesicouterine pouch lies between?
a) Bladder and uterus
b) Uterus and rectum
c) Bladder and rectum
d) Uterus and ovary
Explanation: The vesicouterine pouch is the peritoneal recess between the urinary bladder and the uterus in females. It is anterior to the uterus. Correct answer is a) Bladder and uterus.
Guessed Question 5
Why is pouch of Douglas the lowest point in females?
a) Due to body posture
b) Uterus placement
c) Peritoneal reflections
d) All of the above
Explanation: In standing position, anatomical arrangement and peritoneal reflections make the rectouterine pouch (pouch of Douglas) the lowest point, where fluid accumulates in pathological conditions. Correct answer is d) All of the above.
Guessed Question 6
Pouch of Douglas is clinically accessed via?
a) Laparoscopy
b) Culdocentesis
c) Paracentesis
d) Colonoscopy
Explanation: Culdocentesis is a clinical procedure where fluid is aspirated from the pouch of Douglas via the posterior vaginal fornix to diagnose infections or fluid accumulation. Correct answer is b) Culdocentesis.
Guessed Question 7
Which organ does NOT relate to pouch of Douglas?
a) Uterus
b) Bladder
c) Rectum
d) Small intestine
Explanation: The pouch of Douglas is bordered by uterus and rectum, with bladder more anteriorly. The small intestine does not specifically relate to this peritoneal recess. Correct answer is d) Small intestine.
Guessed Question 8
In males, equivalent of pouch of Douglas is?
a) Rectovesical pouch
b) Vesicouterine pouch
c) Pararectal pouch
d) None
Explanation: In males, the rectovesical pouch lies between the rectum and urinary bladder, analogous to the female pouch of Douglas. It serves as the most dependent peritoneal space in males. Correct answer is a) Rectovesical pouch.
Guessed Question 9
What does accumulation of pus in pouch of Douglas suggest?
a) Appendicitis
b) Pelvic inflammatory disease
c) Peritonitis
d) All of the above
Explanation: Pus accumulation in the pouch of Douglas typically suggests pelvic inflammatory disease, though other infections like appendicitis or peritonitis can also cause fluid collection there. Correct answer is d) All of the above.
Guessed Question 10
Pouch of Douglas is bounded by:
a) Posterior vaginal fornix
b) Uterus
c) Rectum
d) All of the above
Explanation: The pouch of Douglas is anatomically bounded by the posterior vaginal fornix, uterus anteriorly, and rectum posteriorly. This area is clinically important in gynecology. Correct answer is d) All of the above.
Chapter: Anatomy
Topic: Pelvic Nerves
Subtopic: Pain Pathways in Pelvis
Keyword Definitions:
Pudendal nerve: Somatic nerve supplying perineum, external genitalia, and sphincters.
Sciatic nerve: Largest nerve of body, supplies lower limb but not pelvic viscera.
Autonomic nerves: Sympathetic and parasympathetic nerves controlling involuntary pelvic organ function and mediating visceral pain.
Pelvic pain: Often mediated by autonomic nerve fibers transmitting nociceptive signals from pelvic organs.
Clinical significance: Understanding pain pathways aids diagnosis of pelvic disorders like endometriosis or pelvic inflammatory disease.
Visceral vs Somatic pain: Visceral pain is dull, poorly localized, mediated by autonomic fibers; somatic pain is sharp, well localized.
Lead Question - 2013
Pelvic pain is mediated by ?
a) Pudendal nerve
b) Sciatic nerve
c) Autonomic nerves
d) None of the above
Explanation: Pelvic pain, especially from internal pelvic organs like uterus, bladder, or rectum, is primarily mediated by autonomic (sympathetic and parasympathetic) nerves. These nerves carry visceral afferent fibers responsible for dull, poorly localized pain sensations. Pudendal and sciatic nerves are somatic and do not mediate visceral pelvic pain. Correct answer is c) Autonomic nerves.
Guessed Question 2
Which nerve supplies the external genitalia and perineum?
a) Pudendal nerve
b) Sciatic nerve
c) Pelvic splanchnic nerve
d) Obturator nerve
Explanation: The pudendal nerve provides motor and sensory innervation to the external genitalia and perineum, important in voluntary control of sphincters. It does not mediate visceral pelvic pain. Correct answer is a) Pudendal nerve.
Guessed Question 3
Visceral pain in pelvis is typically described as?
a) Sharp and localized
b) Dull and poorly localized
c) Burning
d) Electric shock-like
Explanation: Visceral pain in the pelvis is usually dull and poorly localized due to autonomic nerve mediation. It contrasts with somatic pain, which is sharp and well localized. Correct answer is b) Dull and poorly localized.
Guessed Question 4
Which of the following nerves carries parasympathetic fibers to pelvic organs?
a) Pudendal nerve
b) Pelvic splanchnic nerve
c) Hypogastric nerve
d) Sciatic nerve
Explanation: The pelvic splanchnic nerves (S2-S4) carry parasympathetic fibers to pelvic organs, regulating functions such as bladder contraction and genital erection. These are involved in autonomic control but not in direct somatic pain transmission. Correct answer is b) Pelvic splanchnic nerve.
Guessed Question 5
Sympathetic fibers mediating pelvic pain originate from which spinal segments?
a) T1-T5
b) T10-L2
c) S2-S4
d) L4-L5
Explanation: Sympathetic fibers mediating pelvic visceral pain primarily originate from spinal segments T10 to L2, traveling via hypogastric plexus to pelvic organs. These pathways carry nociceptive signals in disease states. Correct answer is b) T10-L2.
Guessed Question 6
Which of the following is true regarding somatic pelvic pain?
a) Mediated by autonomic nerves
b) Poorly localized
c) Sharp and well localized
d) Does not involve nerve endings
Explanation: Somatic pelvic pain is sharp and well localized because it is mediated by somatic nerves like the pudendal nerve, which carries precise sensory input from skin, muscles, and deeper somatic structures. Correct answer is c) Sharp and well localized.
Guessed Question 7
Pudendal nerve block is used for:
a) Pain relief during childbirth
b) Lower limb surgery
c) Appendectomy
d) Hernia repair
Explanation: Pudendal nerve block is commonly used for analgesia during childbirth, targeting somatic nerves supplying the perineum and external genitalia. It does not block autonomic-mediated visceral pain. Correct answer is a) Pain relief during childbirth.
Guessed Question 8
Which nerve is NOT involved in transmitting pelvic visceral pain?
a) Pelvic splanchnic nerve
b) Hypogastric nerve
c) Pudendal nerve
d) Vagus nerve
Explanation: The pudendal nerve is primarily somatic, serving perineum and external genitalia, and does not carry visceral afferents. Visceral pain is mediated by pelvic splanchnic, hypogastric, and vagus nerves. Correct answer is c) Pudendal nerve.
Guessed Question 9
Visceral pelvic pain is aggravated by:
a) Movement
b) Organ distension
c) Skin irritation
d) Muscle contraction
Explanation: Visceral pelvic pain is often aggravated by organ distension or ischemia due to stretch-sensitive receptors in autonomic nerves. Movement or somatic stimuli typically affect somatic pain. Correct answer is b) Organ distension.
Guessed Question 10
Which of the following is NOT a function of autonomic nerves in pelvis?
a) Regulate bladder contraction
b) Mediate erection
c) Innervate external anal sphincter
d) Transmit visceral pain
Explanation: Autonomic nerves regulate involuntary functions like bladder contraction, genital erection, and visceral pain. The external anal sphincter is innervated by somatic pudendal nerve, not autonomic nerves. Correct answer is c) Innervate external anal sphincter.
Topic: Female Reproductive System
Subtopic: Uterine Anomalies
Keyword Definitions:
Cochleate uterus: Uterus with acute retroflexion, where the body of the uterus is sharply bent backward over the cervix.
Anteflexion: Forward bending of the uterine body over the cervix.
Retroflexion: Backward bending of the uterine body over the cervix.
Uterine anomalies: Variations in uterine shape or structure that can affect fertility or cause symptoms like pain.
Clinical significance: Cochleate uterus may lead to menstrual disorders or infertility due to abnormal uterine positioning.
Cervix: The lower part of the uterus connecting to the vagina, important in childbirth and menstrual flow.
Lead Question - 2013
Cochleate uterus is ?
a) Large uterus
b) Acute anteflexion
c) Acute retroflexion
d) Large cervix
Explanation: Cochleate uterus refers to an abnormal uterine position where the uterine body is sharply retroflexed over the cervix, leading to acute retroflexion. This condition can cause infertility, menstrual irregularities, and pelvic pain. It is not related to large size or anteflexion. Correct answer is c) Acute retroflexion.
Guessed Question 2
Which condition describes forward bending of the uterus?
a) Anteflexion
b) Retroflexion
c) Prolapse
d) Inversion
Explanation: Anteflexion refers to the normal forward bending of the uterus over the cervix. It is a common anatomical variant and not usually associated with clinical problems. Acute retroflexion (cochleate uterus) is the opposite condition. Correct answer is a) Anteflexion.
Guessed Question 3
Major clinical symptom of cochleate uterus may be?
a) Menstrual irregularities
b) Vaginal discharge
c) Asymptomatic
d) Pelvic infection
Explanation: Cochleate uterus may lead to menstrual irregularities and infertility due to mechanical hindrance in menstrual flow or sperm transport. Pelvic pain may also be present due to the abnormal uterine position. Correct answer is a) Menstrual irregularities.
Guessed Question 4
Uterine prolapse is best described as:
a) Downward displacement of uterus
b) Forward bending of uterus
c) Enlargement of uterus
d) Acute retroflexion of uterus
Explanation: Uterine prolapse refers to the downward displacement of the uterus into the vaginal canal, often due to weakening of pelvic support structures. This is different from cochleate uterus, which is a retroflexion. Correct answer is a) Downward displacement of uterus.
Guessed Question 5
Which imaging modality is useful to diagnose uterine position anomalies?
a) Ultrasound
b) X-ray
c) CT Scan
d) PET Scan
Explanation: Ultrasound is the primary imaging modality used to evaluate uterine position and detect anomalies such as cochleate uterus. It is non-invasive and provides real-time anatomical details. Correct answer is a) Ultrasound.
Guessed Question 6
Cochleate uterus may result in difficulty during:
a) Micturition
b) Childbirth
c) Digestion
d) Respiration
Explanation: Cochleate uterus, due to its acute retroflexion, can mechanically obstruct the birth canal and lead to difficulty during childbirth. It is not directly related to digestion or respiration. Correct answer is b) Childbirth.
Guessed Question 7
The cervix connects the uterus to:
a) Rectum
b) Vagina
c) Bladder
d) Peritoneum
Explanation: The cervix is the lower, narrow part of the uterus that connects the uterine cavity with the vagina, allowing passage of menstrual flow and sperm. It does not connect directly to bladder or rectum. Correct answer is b) Vagina.
Guessed Question 8
Which is NOT a common symptom of uterine position anomalies?
a) Dyspareunia
b) Infertility
c) Frequent urination
d) Asthma
Explanation: Uterine position anomalies such as cochleate uterus commonly cause dyspareunia (pain during intercourse), infertility, and urinary symptoms due to pressure effects. Asthma is unrelated. Correct answer is d) Asthma.
Guessed Question 9
Cochleate uterus is best managed by:
a) Hormonal therapy
b) Physiotherapy
c) Surgical correction
d) Antibiotics
Explanation: Severe cases of cochleate uterus with symptoms such as infertility or pain may require surgical correction to reposition the uterus. Hormonal therapy or physiotherapy alone is usually insufficient. Correct answer is c) Surgical correction.
Guessed Question 10
Which of the following is TRUE about retroflexed uterus?
a) Always pathological
b) May be normal variant
c) Causes immediate infertility
d) Must be surgically corrected
Explanation: A retroflexed uterus can be a normal anatomical variant and is often asymptomatic. Not all cases require surgical correction unless associated with symptoms like infertility or pain. Correct answer is b) May be normal variant.
Topic: Gastrointestinal System
Subtopic: Anal Canal Anatomy
Keyword Definitions:
Anal Canal: The terminal part of the large intestine, extending from the rectum to the anus, responsible for controlling defecation.
Internal Anal Sphincter: Involuntary smooth muscle controlling anal tone.
External Anal Sphincter: Voluntary skeletal muscle surrounding the anal canal aiding in continence.
Clinical relevance: Accurate knowledge of anal canal length is important for diagnosing anorectal disorders and planning surgical procedures.
Defecation: The process of expelling feces through the anal canal.
Perianal Region: The area surrounding the anus, important in clinical examination of anal canal disorders.
Lead Question - 2013
Length of anal canal?
a) 10 - 15 mm
b) 15 - 20 mm
c) 25 - 30 mm
d) 35 - 40 mm
Explanation: The anal canal is approximately 25 to 30 mm (2.5 – 3 cm) in length. It lies between the rectum and the anus and is clinically significant in conditions like anal fissures, hemorrhoids, and anorectal tumors. Proper anatomical knowledge aids in surgeries and clinical diagnosis. Correct answer is c) 25 - 30 mm.
Guessed Question 2
The internal anal sphincter is made up of:
a) Skeletal muscle
b) Smooth muscle
c) Fibrous tissue
d) Cartilage
Explanation: The internal anal sphincter is composed of involuntary smooth muscle and is responsible for maintaining baseline anal tone. It is under autonomic nervous system control and differs from the external anal sphincter which is skeletal muscle. Correct answer is b) Smooth muscle.
Guessed Question 3
External anal sphincter is innervated by:
a) Pelvic splanchnic nerves
b) Pudendal nerve
c) Hypogastric plexus
d) Vagus nerve
Explanation: The external anal sphincter is composed of voluntary skeletal muscle and is innervated by the pudendal nerve (S2-S4). This enables conscious control over defecation. Correct answer is b) Pudendal nerve.
Guessed Question 4
Most common site for anal fissure is:
a) Anterior midline
b) Posterior midline
c) Lateral wall
d) Superior wall
Explanation: The most common site of anal fissure is the posterior midline of the anal canal, due to less vascularity in that region. Anterior fissures are less common. Correct answer is b) Posterior midline.
Guessed Question 5
The anal columns contain which vessels?
a) Arterial arcades
b) Venous plexus
c) Lymphatic channels
d) None of the above
Explanation: Anal columns contain the terminal branches of the superior rectal artery and associated venous plexus. These columns are clinically important as the site where internal hemorrhoids develop. Correct answer is b) Venous plexus.
Guessed Question 6
Upper half of anal canal is lined by:
a) Squamous epithelium
b) Columnar epithelium
c) Transitional epithelium
d) Cuboidal epithelium
Explanation: The upper half of the anal canal is lined by columnar epithelium, which is continuous with the rectal lining. The lower half is lined by stratified squamous epithelium. Correct answer is b) Columnar epithelium.
Guessed Question 7
Which artery supplies the anal canal?
a) Inferior mesenteric artery
b) Superior rectal artery
c) Middle rectal artery
d) Both b and c
Explanation: The anal canal receives blood supply from the superior rectal artery (a branch of the inferior mesenteric artery) and the middle rectal artery (from internal iliac artery). This dual supply is important clinically for procedures involving the anal canal. Correct answer is d) Both b and c.
Guessed Question 8
Primary symptom of anal canal pathology is:
a) Abdominal pain
b) Rectal bleeding
c) Headache
d) Dysphagia
Explanation: Rectal bleeding is a primary symptom in pathologies of the anal canal, such as hemorrhoids, fissures, and carcinoma. Abdominal pain is more general, and headache and dysphagia are unrelated. Correct answer is b) Rectal bleeding.
Guessed Question 9
The pectinate line in the anal canal is important because:
a) Marks change in epithelial type
b) Marks different lymphatic drainage
c) Marks different venous drainage
d) All of the above
Explanation: The pectinate line is clinically significant as it marks the transition from columnar to squamous epithelium, changes in lymphatic and venous drainage, and the site dividing internal from external hemorrhoids. Correct answer is d) All of the above.
Guessed Question 10
Which nerve supplies sensation below the pectinate line?
a) Pelvic splanchnic nerves
b) Pudendal nerve
c) Vagus nerve
d) Hypogastric nerve
Explanation: The area below the pectinate line is supplied by the pudendal nerve, allowing somatic sensation (pain, touch, temperature). Above the pectinate line, autonomic innervation predominates. Correct answer is b) Pudendal nerve.
Topic: Genitourinary System
Subtopic: Congenital Anomalies of Kidney
Keyword Definitions:
Ectopic Kidney: A kidney located in an abnormal position, typically in the pelvis instead of the lumbar region.
Renal Duplication: A congenital anomaly where there are two ureters or two renal pelvises from one kidney.
Horse Shoe Kidney: A congenital fusion anomaly where the lower poles of both kidneys are connected, forming a U-shape.
Renal Agenesis: A congenital absence of one or both kidneys, leading to significant clinical implications.
Congenital Anomaly: Structural or functional abnormality present from birth due to developmental defects.
Clinical Relevance: Knowledge of kidney anomalies is crucial for diagnosing hypertension, urinary obstruction, and planning surgeries.
Lead Question - 2013
Most common congenital anomaly of kidney?
a) Ectopic kidney
b) Renal duplication
c) Horse shoe kidney
d) Renal agenesis
Explanation: The most common congenital anomaly of the kidney is renal duplication, where two ureters or two renal pelvises arise from a single kidney. It is often asymptomatic but can predispose to infections and obstruction. Early diagnosis helps in management. Correct answer is b) Renal duplication.
Guessed Question 2
In horseshoe kidney, the fusion commonly occurs at:
a) Upper poles
b) Lower poles
c) Mid poles
d) No fusion
Explanation: In horseshoe kidney, the most common fusion is at the lower poles. This leads to the kidney being fixed under the inferior mesenteric artery, often causing urinary tract obstruction or infections. Recognizing this helps in clinical evaluation. Correct answer is b) Lower poles.
Guessed Question 3
Ectopic kidney is most commonly located in:
a) Thoracic region
b) Pelvis
c) Retroperitoneal space
d) Contralateral kidney area
Explanation: An ectopic kidney is most commonly located in the pelvic region due to incomplete ascent during development. It may cause urinary tract infections or obstruction but is often asymptomatic. Correct answer is b) Pelvis.
Guessed Question 4
Unilateral renal agenesis is associated with:
a) Complete absence of both kidneys
b) Absence of one kidney with compensatory hypertrophy of the other
c) Both kidneys present but hypoplastic
d) Absence of ureters only
Explanation: Unilateral renal agenesis means one kidney is absent and the other compensates by hypertrophy. Patients may be asymptomatic but are at risk of hypertension and renal insufficiency later. Bilateral agenesis is lethal. Correct answer is b) Absence of one kidney with compensatory hypertrophy of the other.
Guessed Question 5
Renal duplication predisposes to:
a) Urinary tract infections
b) Vesicoureteral reflux
c) Ureteral obstruction
d) All of the above
Explanation: Renal duplication increases the risk of urinary tract infections, vesicoureteral reflux, and ureteral obstruction due to abnormal anatomy of ureters and their insertion into the bladder. Early identification prevents complications. Correct answer is d) All of the above.
Guessed Question 6
Which imaging modality is preferred for detecting congenital renal anomalies?
a) X-ray abdomen
b) MRI
c) Ultrasound
d) PET scan
Explanation: Ultrasound is the preferred, non-invasive imaging modality to detect congenital renal anomalies like ectopic kidney, horseshoe kidney, or renal duplication. It provides good anatomical detail without radiation exposure, especially useful in children. Correct answer is c) Ultrasound.
Guessed Question 7
Renal agenesis is most commonly:
a) Unilateral
b) Bilateral
c) Equally unilateral or bilateral
d) Not congenital
Explanation: Unilateral renal agenesis is more common than bilateral. Bilateral agenesis is incompatible with life and leads to Potter sequence. Unilateral cases are often asymptomatic, found incidentally or during work-up for hypertension. Correct answer is a) Unilateral.
Guessed Question 8
Horseshoe kidney is associated with increased risk of:
a) Ureteropelvic junction obstruction
b) Kidney stones
c) Renal tumors
d) All of the above
Explanation: Horseshoe kidney predisposes patients to ureteropelvic junction obstruction, increased risk of kidney stones due to impaired drainage, and higher risk of renal tumors such as Wilms tumor. Awareness helps in screening and management. Correct answer is d) All of the above.
Guessed Question 9
Which artery crosses over the isthmus of a horseshoe kidney?
a) Inferior mesenteric artery
b) Superior mesenteric artery
c) Renal artery
d) External iliac artery
Explanation: In a horseshoe kidney, the inferior mesenteric artery crosses anterior to the isthmus, often limiting ascent of kidneys during development and causing the fusion. This is significant for surgical and radiological approaches. Correct answer is a) Inferior mesenteric artery.
Guessed Question 10
Renal duplication anomaly is more common in:
a) Males
b) Females
c) Equal in both sexes
d) Unknown gender predilection
Explanation: Renal duplication is more common in females and may be asymptomatic or present with recurrent urinary infections or obstruction. Awareness assists in early diagnosis, preventing complications. Correct answer is b) Females.
Topic: Ear Anatomy
Subtopic: Middle Ear Structure
Keyword Definitions:
Middle Ear: The air-filled cavity between the external ear and inner ear containing auditory ossicles.
Tympanic Membrane: A thin membrane that separates the external ear canal from the middle ear and vibrates in response to sound.
Jugular Bulb: The dilated portion of the internal jugular vein located near the base of the skull, below the middle ear.
Tegmen Tympani: A thin plate of bone forming the roof (superior wall) of the middle ear, separating it from the cranial cavity.
Clinical Relevance: Defects in the tegmen tympani can lead to cerebrospinal fluid leak or infections spreading between the middle ear and cranial cavity.
Lead Question - 2013
Superior wall of middle ear is formed by?
a) Tympanic membrane
b) Jugular bulb
c) Tegmen tympani
d) None
Explanation: The superior wall (roof) of the middle ear is formed by the tegmen tympani, a thin bony plate separating the middle ear from the middle cranial fossa. It prevents transmission of infection and protects the brain. Damage may result in CSF leak or encephalitis. Correct answer is c) Tegmen tympani.
Guessed Question 2
Defect in tegmen tympani may cause?
a) Hearing loss
b) Cerebrospinal fluid (CSF) leak
c) Vertigo
d) Tinnitus
Explanation: A defect in the tegmen tympani can create a communication between the cranial cavity and the middle ear, leading to a CSF leak. This raises risk of meningitis and requires surgical repair. Correct answer is b) Cerebrospinal fluid (CSF) leak.
Guessed Question 3
The middle ear cavity contains:
a) Cochlea
b) Auditory ossicles
c) Semicircular canals
d) Oval window only
Explanation: The middle ear contains three auditory ossicles – malleus, incus, and stapes – which transmit sound vibrations from the tympanic membrane to the oval window of the inner ear. The cochlea and semicircular canals are part of the inner ear. Correct answer is b) Auditory ossicles.
Guessed Question 4
The floor of the middle ear is formed by:
a) Tegmen tympani
b) Jugular wall
c) Tympanic membrane
d) Mastoid wall
Explanation: The floor (inferior wall) of the middle ear is formed by a thin plate of bone separating the middle ear from the jugular bulb and internal jugular vein. This helps prevent vascular injury during ear surgery. Correct answer is b) Jugular wall.
Guessed Question 5
The roof of middle ear separates it from?
a) External auditory canal
b) Brain (middle cranial fossa)
c) Cochlea
d) Eustachian tube
Explanation: The tegmen tympani forms the roof of the middle ear and separates the middle ear cavity from the brain's middle cranial fossa, protecting the brain from infection and pressure changes. Correct answer is b) Brain (middle cranial fossa).
Guessed Question 6
In chronic otitis media, which structure may be eroded?
a) Tympanic membrane
b) Tegmen tympani
c) Malleus
d) Cochlea
Explanation: In chronic otitis media, particularly with cholesteatoma, the tegmen tympani may erode, creating risk for serious intracranial complications like meningitis or brain abscess. Surgical intervention is critical in such cases. Correct answer is b) Tegmen tympani.
Guessed Question 7
Jugular bulb lies:
a) Above tegmen tympani
b) Below floor of middle ear
c) Lateral to stapes
d) Posterior to cochlea
Explanation: The jugular bulb lies below the floor of the middle ear and represents the superior part of the internal jugular vein. It must be considered carefully during ear surgeries to prevent vascular injury. Correct answer is b) Below floor of middle ear.
Guessed Question 8
The tympanic membrane separates:
a) External auditory canal and cochlea
b) External ear and middle ear
c) Middle ear and inner ear
d) External ear and inner ear
Explanation: The tympanic membrane separates the external auditory canal from the middle ear. It vibrates in response to sound waves and transmits them via the auditory ossicles. Inner ear structures are separated by the oval and round windows. Correct answer is b) External ear and middle ear.
Guessed Question 9
Clinical test to assess middle ear function is:
a) Rinne test
b) Weber test
c) Tympanometry
d) Audiometry
Explanation: Tympanometry is a clinical test that evaluates the function of the middle ear by measuring eardrum compliance and middle ear pressure. It is particularly useful for detecting fluid, perforations, or dysfunction of the ossicles or tegmen tympani. Correct answer is c) Tympanometry.
Guessed Question 10
Damage to tegmen tympani may result in which of the following symptoms?
a) Hearing loss
b) Tinnitus
c) CSF rhinorrhea
d) Facial paralysis
Explanation: Damage to the tegmen tympani can cause a defect between the middle cranial fossa and the middle ear, leading to CSF rhinorrhea. This is a dangerous clinical condition and must be promptly addressed to avoid infection or other complications. Correct answer is c) CSF rhinorrhea.
Topic: Nerve Supply of Larynx
Subtopic: Innervation of Larynx
Keyword Definitions:
Larynx: An organ located in the neck involved in breathing, producing sound, and protecting the trachea against food aspiration.
Superior Laryngeal Nerve: Branch of the vagus nerve (CN X) that provides sensation above the vocal cords and motor supply to the cricothyroid muscle.
Recurrent Laryngeal Nerve: Branch of the vagus nerve looping around major arteries; provides motor supply to intrinsic laryngeal muscles and sensation below the vocal cords.
Glossopharyngeal Nerve: Cranial nerve IX, involved in taste, sensory supply to pharynx, and carotid body functions, not directly involved in laryngeal innervation.
External Laryngeal Nerve: Branch of the superior laryngeal nerve supplying the cricothyroid muscle.
Lead Question - 2013
Nerve supply of larynx above level of vocal cord?
a) Superior laryngeal
b) Recurrent laryngeal
c) Glossopharyngeal
d) External laryngeal
Explanation: The larynx above the vocal cords receives sensory innervation from the internal branch of the superior laryngeal nerve, which is a branch of the vagus nerve (CN X). This nerve is essential for protective reflexes and sensation. Recurrent laryngeal supplies below the vocal cords. Correct answer is a) Superior laryngeal.
Guessed Question 2
Which nerve supplies the cricothyroid muscle?
a) Recurrent laryngeal
b) Internal laryngeal
c) External laryngeal
d) Glossopharyngeal
Explanation: The external branch of the superior laryngeal nerve supplies the cricothyroid muscle, responsible for tensing the vocal cords and modulating pitch. Damage causes monotone voice. Recurrent laryngeal nerve supplies other intrinsic laryngeal muscles. Correct answer is c) External laryngeal.
Guessed Question 3
Recurrent laryngeal nerve provides motor supply to:
a) Cricothyroid
b) All intrinsic laryngeal muscles except cricothyroid
c) Only vocalis muscle
d) None of the above
Explanation: The recurrent laryngeal nerve supplies motor innervation to all intrinsic muscles of the larynx except the cricothyroid, which is supplied by the external laryngeal nerve. This is clinically significant in thyroid surgeries. Correct answer is b) All intrinsic laryngeal muscles except cricothyroid.
Guessed Question 4
Sensory supply below vocal cords is provided by?
a) Glossopharyngeal nerve
b) Internal laryngeal nerve
c) Recurrent laryngeal nerve
d) External laryngeal nerve
Explanation: The recurrent laryngeal nerve provides sensory innervation to the larynx below the vocal cords and motor supply to the intrinsic muscles, except the cricothyroid. This is important for cough reflex and surgical risk. Correct answer is c) Recurrent laryngeal nerve.
Guessed Question 5
Injury to superior laryngeal nerve results in:
a) Loss of sensation below vocal cords
b) Loss of high-pitched voice
c) Complete voice loss
d) Horner's syndrome
Explanation: Injury to the superior laryngeal nerve, particularly its external branch, affects the cricothyroid muscle, resulting in loss of pitch modulation, especially high-pitched sounds. The recurrent laryngeal nerve injury causes hoarseness but not high-pitched voice loss specifically. Correct answer is b) Loss of high-pitched voice.
Guessed Question 6
Internal branch of superior laryngeal nerve provides:
a) Motor to intrinsic laryngeal muscles
b) Sensory above vocal cords
c) Sensory below vocal cords
d) Motor to cricothyroid
Explanation: The internal branch of superior laryngeal nerve provides sensory innervation to the mucosa of the larynx above the vocal cords, important in protective airway reflexes like cough. It does not supply motor fibers. Correct answer is b) Sensory above vocal cords.
Guessed Question 7
Which nerve is most at risk during thyroid surgery?
a) Internal laryngeal
b) Recurrent laryngeal
c) External laryngeal
d) Glossopharyngeal
Explanation: The recurrent laryngeal nerve is particularly vulnerable during thyroidectomy, as it courses close to the thyroid gland. Injury leads to vocal cord paralysis, hoarseness, or airway obstruction. Careful dissection avoids damage. Correct answer is b) Recurrent laryngeal.
Guessed Question 8
The superior laryngeal nerve is a branch of which cranial nerve?
a) CN IX
b) CN X
c) CN XI
d) CN XII
Explanation: The superior laryngeal nerve is a branch of the vagus nerve (Cranial Nerve X). It divides into internal and external branches, providing sensory and motor innervation of the larynx. Correct answer is b) CN X.
Guessed Question 9
Function of cricothyroid muscle is to:
a) Adduct vocal cords
b) Abduct vocal cords
c) Tense vocal cords
d) Relax vocal cords
Explanation: The cricothyroid muscle, innervated by the external branch of the superior laryngeal nerve, tenses the vocal cords, increasing pitch. It is essential for modulating voice frequency. Injury leads to monotone voice. Correct answer is c) Tense vocal cords.
Guessed Question 10
Lesion of internal laryngeal nerve results in:
a) Loss of cough reflex
b) Hoarseness
c) Loss of taste
d) Difficulty swallowing
Explanation: Lesion of the internal laryngeal nerve results in loss of sensation above the vocal cords, impairing the cough reflex and increasing the risk of aspiration pneumonia. It does not cause motor deficits. Correct answer is a) Loss of cough reflex.
Topic: Nerve Supply of Larynx
Subtopic: Innervation of Intrinsic Laryngeal Muscles
Keyword Definitions:
Recurrent Laryngeal Nerve: Branch of the vagus nerve supplying all intrinsic laryngeal muscles except the cricothyroid.
Cricothyroid Muscle: Muscle that adjusts tension of vocal cords, supplied by the external branch of superior laryngeal nerve.
Vocalis Muscle: Intrinsic laryngeal muscle controlling fine tension of the vocal cords.
Thyroarytenoid Muscle: Muscle relaxing vocal cords, aiding in sound modulation.
Interarytenoid Muscle: Muscle that adducts arytenoid cartilages, closing the posterior laryngeal inlet.
Lead Question - 2013
Which muscle of larynx is not supplied by recurrent laryngeal nerve?
a) Vocalis
b) Thyroarytenoid
c) Cricothyroid
d) Interarytenoid
Explanation: The cricothyroid muscle is the only intrinsic laryngeal muscle not supplied by the recurrent laryngeal nerve. Instead, it receives innervation from the external branch of the superior laryngeal nerve and is responsible for tensing the vocal cords to modulate voice pitch. Correct answer is c) Cricothyroid.
Guessed Question 2
Lesion of recurrent laryngeal nerve causes:
a) Loss of voice pitch modulation
b) Hoarseness or aphonia
c) Loss of sensation above vocal cords
d) Loss of sensation below vocal cords
Explanation: A lesion of the recurrent laryngeal nerve affects motor supply to all intrinsic laryngeal muscles except the cricothyroid, resulting in hoarseness, voice fatigue, or even aphonia. Sensory loss below the vocal cords may also occur. Correct answer is b) Hoarseness or aphonia.
Guessed Question 3
External branch of superior laryngeal nerve innervates:
a) Vocalis
b) Cricothyroid
c) Thyroarytenoid
d) Interarytenoid
Explanation: The external branch of the superior laryngeal nerve provides motor innervation to the cricothyroid muscle, which is crucial for regulating vocal cord tension and pitch. Other intrinsic muscles are supplied by the recurrent laryngeal nerve. Correct answer is b) Cricothyroid.
Guessed Question 4
Internal branch of superior laryngeal nerve provides:
a) Motor supply to cricothyroid
b) Sensory to larynx above vocal cords
c) Sensory to larynx below vocal cords
d) Motor supply to interarytenoid
Explanation: The internal branch of the superior laryngeal nerve supplies sensory innervation to the laryngeal mucosa above the vocal cords. It does not have a motor function. Recurrent laryngeal nerve supplies motor innervation below vocal cords. Correct answer is b) Sensory to larynx above vocal cords.
Guessed Question 5
Recurrent laryngeal nerve arises from the vagus nerve at which level on the right side?
a) Arch of aorta
b) Subclavian artery
c) Common carotid artery
d) Carotid sheath
Explanation: On the right side, the recurrent laryngeal nerve arises from the vagus nerve at the level of the subclavian artery, looping around it before ascending toward the larynx. This anatomical pathway makes it vulnerable during surgery. Correct answer is b) Subclavian artery.
Guessed Question 6
Which structure is at risk of injury in thyroid surgery?
a) Internal laryngeal nerve
b) Recurrent laryngeal nerve
c) External carotid artery
d) Vagus nerve trunk
Explanation: The recurrent laryngeal nerve is at risk during thyroid surgeries because of its close anatomical relationship to the thyroid gland. Injury leads to vocal cord paralysis, hoarseness, or airway obstruction. Careful dissection is required to avoid this complication. Correct answer is b) Recurrent laryngeal nerve.
Guessed Question 7
Which of the following is NOT an intrinsic laryngeal muscle?
a) Thyroarytenoid
b) Cricothyroid
c) Sternohyoid
d) Vocalis
Explanation: The sternohyoid muscle is an extrinsic laryngeal muscle involved in depressing the hyoid bone and larynx. The intrinsic muscles, such as thyroarytenoid, cricothyroid, and vocalis, control vocal cord tension and position. Correct answer is c) Sternohyoid.
Guessed Question 8
Which nerve carries parasympathetic fibers to the larynx?
a) Glossopharyngeal
b) Vagus
c) Hypoglossal
d) Spinal accessory
Explanation: The vagus nerve (CN X) carries parasympathetic fibers to the larynx, in addition to its sensory and motor functions. It plays a role in regulating secretions and blood flow in the larynx. Correct answer is b) Vagus.
Guessed Question 9
The internal branch of superior laryngeal nerve enters the larynx through which structure?
a) Cricothyroid membrane
b) Thyrohyoid membrane
c) Jugular foramen
d) Carotid canal
Explanation: The internal branch of the superior laryngeal nerve penetrates the thyrohyoid membrane to provide sensory innervation to the larynx above the vocal cords. This passage is clinically important during procedures like laryngeal blocks. Correct answer is b) Thyrohyoid membrane.
Guessed Question 10
External laryngeal nerve is a branch of which nerve?
a) Vagus nerve
b) Glossopharyngeal nerve
c) Hypoglossal nerve
d) Facial nerve
Explanation: The external laryngeal nerve is a branch of the vagus nerve (CN X) and provides motor innervation to the cricothyroid muscle. Its damage affects pitch modulation, leading to monotone voice. Correct answer is a) Vagus nerve.
Topic: Muscles of Facial Expression
Subtopic: Orbicularis Oculi and Related Muscles
Keyword Definitions:
Orbicularis Oculi: Circular muscle around the eye that enables eyelid closure and blinking.
Levator Labii Superioris: Muscle elevating upper lip; involved in facial expression.
Corrugator Supercilii: Muscle that draws eyebrows medially and downward, producing frowning.
Levator Palpebrae Superioris: Muscle responsible for raising the upper eyelid; not involved in winking.
Lead Question - 2013
Which muscle plays a role in winking?
a) Levator labii superioris
b) Orbicularis oculi
c) Corrugator supercilli
d) Levator palpebrae
Explanation: The orbicularis oculi muscle is the primary muscle responsible for eyelid closure and actions like blinking and winking. It encircles the eye and contracts to close the eyelids voluntarily or reflexively. Other listed muscles serve different facial functions. The correct answer is b) Orbicularis oculi.
Guessed Question 2
Which branch of the facial nerve supplies the orbicularis oculi?
a) Temporal
b) Zygomatic
c) Buccal
d) Mandibular
Explanation: The temporal and zygomatic branches of the facial nerve (cranial nerve VII) innervate the orbicularis oculi muscle, controlling eyelid movements such as blinking and winking. These branches are crucial in facial nerve function assessment. Correct answer is a) Temporal and b) Zygomatic.
Guessed Question 3
Paralysis of orbicularis oculi leads to which clinical sign?
a) Lagophthalmos
b) Ptosis
c) Diplopia
d) Strabismus
Explanation: Lagophthalmos refers to incomplete eyelid closure, often seen in facial nerve (VII) palsy affecting the orbicularis oculi. This can lead to exposure keratitis and eye dryness due to impaired blinking. The correct answer is a) Lagophthalmos.
Guessed Question 4
The levator palpebrae superioris is innervated by which nerve?
a) Oculomotor nerve (CN III)
b) Facial nerve (CN VII)
c) Trigeminal nerve (CN V)
d) Accessory nerve (CN XI)
Explanation: The levator palpebrae superioris muscle is innervated by the oculomotor nerve (CN III) and elevates the upper eyelid. Dysfunction may lead to ptosis, but it does not contribute to winking. Correct answer is a) Oculomotor nerve (CN III).
Guessed Question 5
Which of the following muscles is responsible for frowning?
a) Orbicularis oculi
b) Corrugator supercilli
c) Levator labii superioris
d) Levator palpebrae superioris
Explanation: The corrugator supercilli muscle draws the eyebrows medially and downward, creating vertical wrinkles above the nose, producing a frown. Orbicularis oculi closes eyelids but does not produce frown. Correct answer is b) Corrugator supercilli.
Guessed Question 6
In Bell’s palsy, which muscle is typically affected?
a) Orbicularis oculi
b) Sternocleidomastoid
c) Masseter
d) Temporalis
Explanation: Bell’s palsy involves unilateral facial nerve (CN VII) paralysis, impairing the orbicularis oculi. This results in inability to close the eye fully, leading to dryness and risk of keratitis. Other muscles are innervated differently. Correct answer is a) Orbicularis oculi.
Guessed Question 7
Which muscle elevates the upper lip?
a) Orbicularis oculi
b) Levator labii superioris
c) Corrugator supercilli
d) Levator palpebrae superioris
Explanation: The levator labii superioris elevates the upper lip, aiding facial expressions such as smiling or showing disdain. It is not involved in eyelid movements. Correct answer is b) Levator labii superioris.
Guessed Question 8
The orbicularis oculi muscle is divided into which parts?
a) Palpebral and orbital parts
b) Nasal and palpebral parts
c) Orbital and maxillary parts
d) Palpebral and zygomatic parts
Explanation: The orbicularis oculi muscle is composed of two parts: the palpebral part (involved in gentle eyelid closure such as blinking or winking) and the orbital part (responsible for forceful closure of the eyelids). Correct answer is a) Palpebral and orbital parts.
Guessed Question 9
Which artery supplies blood to orbicularis oculi muscle?
a) Facial artery
b) Ophthalmic artery
c) Maxillary artery
d) External carotid artery
Explanation: The ophthalmic artery, a branch of the internal carotid artery, provides blood supply to the orbicularis oculi muscle. It is critical for maintaining eyelid function and ocular surface health. Correct answer is b) Ophthalmic artery.
Guessed Question 10
Which clinical test assesses orbicularis oculi function?
a) Corneal reflex test
b) Visual acuity test
c) Rinne test
d) Weber test
Explanation: The corneal reflex test assesses the sensory and motor components of blinking, evaluating the function of the trigeminal (sensory) and facial (motor to orbicularis oculi) nerves. Lack of eyelid closure indicates dysfunction of the orbicularis oculi. Correct answer is a) Corneal reflex test.